No Association between Urogenital Schistosomiasis and HIV Infection among Children in Ore Community, Southwestern Nigeria

Aim: To determine if there was any association between urogenital schistosomiasis and HIV infection among children in Ore Community, Southwestern Nigeria. Methodology: Urine samples were collected from 438 children and examined microscopically for ova of Schistosoma haematobium. A sample of 3 ml of blood was drawn from each participant for HIV test. Antibodies to HIV were determined using Determine HIV1/2 kit, Unigold kit and enzyme linked immunosorbent assay (ELISA). Results: The overall prevalence of S. haematobium infection was 30.1% while that of HIV infection was 0.9%. None of the 132 S. haematobium infected children had HIV infection while 1.3% of the 306 children negative for S. haematobium were positive for HIV test. Conclusion: This study did not identify an association between urogenital schistosomiasis and HIV infection among children in Ore, Southwestern Nigeria. Therefore, urogenital schistosomiasis may not play a significant role in the spread of HIV infection in a locality where HIV prevalence is low.

Prevalence of Syphilis among Pregnant Women in Two Health Care Facilites in South Western Nigeria.

Aims: The prevalence of syphilis has been reported to be on the increase worldwide as a result of the HIV/AIDS pandemic. Maternal syphilis puts the fetus at risk of congenital syphilis with the attendant health risks including intrauterine death. This study was carried out to determine the seroprevalence among pregnant women attending antenatal care unit of two tertiary care facilities in South Western Nigeria. Study Design: A Cross-sectional study was carried out. Place and Duration of Study: LAUTECH Teaching Hospital, Osogbo and State Specialist Hospital, Osogbo, Nigeria from October 2012 to May 2013. Methodology: Three hundred and ninety-four pregnant women were recruited for this cross-sectional descriptive study carried out from October 2012 to May 2013. A semistructured questionnaire for socio-demographic information was administered and venous blood samples collected after obtaining informed consent and giving a health talk on mother-to-child transmission of Human Immunodeficiency Virus. Screening for syphilis was done using the qualitative Rapid Plasma Reagin (RPR) test. All reactive sera then had their RPR titre quantified. The confirmatory test for reactive sera was carried out using the Treponema pallidum haemagglutination (TPHA) test. Results: Eight (2%) of the 394 samples were reactive for RPR; while 4(1.0%) were positive for THPA, giving a 1.0% seroprevalence rate. Out of all the women positive for RPR, most (75%) were without any formal education while the remaining 2 had only primary education. All 4 samples that were confirmed positive by THPA were from women with no formal education. Of the 8 positive sample for RPR titre values ranged from 1:2 to 1;8 with higher titres found in those that were TPHA positive. Conclusion: Even though the study recorded low prevalence rate of syphilis in both facilities, it is important to note that the cases were asymptomatic. Therefore routine screening for syphilis in antenatal clinic should be encouraged to prevent mother to child transmission of syphilis.

Allelic diversity of merozoite surface protein 2 gene of P falciparum among children in Osogbo, Nigeria / Diversidad alélica del gen de la proteína de superficie del merozoíto 2 del P falciparum entre los niños de Osogobo, en Nigeria

The genetic diversity of Plasmodium falciparum (P falciparum) infections in humans is implicated in the pathogenesis of malaria. This study provides the first estimate of the genetic diversity and genotype multiplicity of Plasmodium falciparum infection in children with uncomplicated P falciparum malaria in Osogbo, Nigeria. One hundred and one isolates were used for analysis of parasite population polymorphism and genotyped by nested-PCR of merozoite surface protein 2 (MSP2) block 3. Amplicons were obtained for all the 101 genotyped samples in MSP2 PCR with 9 alleles varying in size between 300 and 800 base pair. Thirty-three (31.7%) samples had FC27 allele while 27 (26.7%) had 3D7 allele and 35 (34.7%) had mixed alleles (3D7+FC27). The Multiplicity of Infection (MOI) in the population was 1.6. Children in the age group of > 4-8 years had the highest number of different genotypes in their samples (1.8). The number of MSP2 bands per isolate was lower in the older age group (1.3) but the difference was not statistically significant. Children with parasite density range 5001-10 000 had the highest MOI of 2 while those with parasite density range 1000-5000 had the lowest of1.5. In conclusion, the present study shows that the field isolates are highly diverse in respect ofMSP2 and multiplicity of infection was neither age nor parasite density dependent in the study population.

La diversidad genética de las infecciones por Plasmodium falciparum en los humanos se halla implícita en la patogénesis de la malaria. Este estudio proporciona un primer estimado de la diversidad genética y multiplicidad del genotipo de la infección por Plasmodium falciparum en los niños con malaria por P falciparum malaria sin complicaciones en Osogbo, Nigeria. Ciento un aislados fueron usados para el análisis del polimorfismo de la población parasitaria, y genotipificados mediante reacción en cadena de la polimerasa (RCP) anidada de la proteína de superficie del merozoíto 2 (MSP2) bloque 3. Se obtuvieron amplicones para las 101 muestras genotipificadas con RCP de MSP2, con 9 alelos variando en tamaño entre 300 y 800 par de bases. Treinta y tres (31.7%) muestras tenían el alelo FC27 mientras 27 (26.7%) tenían el alelo 3D7 y 35 (34.7%) tenían alelos mezclado (3D7+FC27). La multiplicidad de infección (MOI) en la población fue 1.6. Los niños en el grupo etario de > 4-8 años tenían el número más alto de genotipos diferentes en sus muestras (1.8). El número de bandas de MSP2 por aislado era más bajo en el grupo etario de mayor edad (1.3) pero la diferencia no era estadísticamente significativa. Los niños con un rango de densidad parasitaria 5001-10 000 tenían el MOI más alto equivalente a 2, mientras aquéllos con rango de densidad parasitaria 1000-5000 tenían el MOI más bajo equivalente a 1.5. En conclusión, el presente estudio muestra que los aislados de campo son altamente diversos con respecto al MSP2, y que la multiplicidad de la infección no depende ni de la edad ni de la densidad parasitaria de la población en estudio.

Chloroquine resistant Plasmodium falciparum malaria in Osogbo Nigeria: efficacy of amodiaquine + sulfadoxine-pyrimethamine and chloroquine + chlorpheniramine for treatment

Chloroquine (CQ) resistance in Plasmodium falciparum contributes to increasing malaria-attributable morbidity and mortality in Sub-Saharan Africa. Despite a change in drug policy, continued prescription of CQ did not abate. Therefore the therapeutic efficacy of CQ in uncomplicated falciparum malaria patients was assessed in a standard 28-day protocol in 116 children aged between six and 120 months in Osogbo, Southwest Nigeria. Parasitological and clinical assessments of response to treatment showed that 72 (62.1 percent) of the patients were cured and 44 (37.9 percent) failed the CQ treatment. High initial parasite density and young age were independent predictors for early treatment failure. Out of the 44 patients that failed CQ, 24 received amodiaquine + sulphadoxine/pyrimethamine (AQ+SP) and 20 received chlorpheniramine + chloroquine (CH+CQ) combinations. Mean fever clearance time in those treated with AQ+SP was not significantly different from those treated with CH+CQ (p = 0.05). There was no significant difference in the mean parasite density of the two groups. The cure rate for AQ+SP group was 92 percent while those of CH+CQ was 85 percent. There was a significant difference in parasite clearance time (p = 0.01) between the two groups. The 38 percent treatment failure for CQ reported in this study is higher than the 10 percent recommended by World Health Organization in other to effect change in antimalarial treatment policy. Hence we conclude that CQ can no more be solely relied upon for the treatment of falciparum malaria in Osogbo, Nigeria. AQ+SP and CH+CQ are effective in the treatment of acute uncomplicated malaria and may be considered as useful alternative drugs in the absence of artemisinin-based combination therapies.